Stovall TG, Ling FW. Please try after some time.Get new journal Tables of Contents sent right to your email inbox (Level I) Maymon R, Shulman A. (Cost-analysis)72. Obstet Gynecol 2017;130:366–73.

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Systematic review evidence shows a failure rate of 14.3% or higher with methotrexate when pretreatment hCG levels are higher than 5,000 mIU/mL compared with a 3.7% failure rate for hCG levels less than 5,000 mIU/mL (There are three published protocols for the administration of methotrexate to treat ectopic pregnancy: 1) a single-dose protocol (The overall treatment success of systemic methotrexate for ectopic pregnancy, defined as resolution of the ectopic pregnancy without the need for surgery, in observational studies ranges from approximately 70% to 95% (*Stovall TG, Ling FW. Pisarska MD, Carson SA, Buster JE.

(Level III)58. your express consent. Description: Aim of this paper is to present possible treatment option in case of methotrexate failure, still keeping the postulates of minimal invasive surgery. (Cost-analysis)43. Mehta TS, Levine D, Beckwith B. Folder Name:

Ectopic pregnancy: evolution after treatment with transvaginal methotrexate. (Level I)57. PLoS One 2016;11:e0152343. But, the third phase of methotrexate elimination (redistribution from tissues), patients could be exposed to methotrexate for longer periods of time, possibly mimicking the common error of daily vs weekly oral methotrexate. (Level III)17. Wolters Kluwer Health Fertil Steril 2004;81:1225–8. Patients should be advised to avoid folic acid supplements, foods that contain folic acid, and nonsteroidal antiinflammatory drugs during therapy because these products may decrease the efficacy of methotrexate. The clinical ramifications of this are unknown. Fertil Steril 2008;90:1579–82.

Obstet Gyne-col 2015;125:1258–67.

(Level II-3)50. Abstracts of research presented at symposia and scientific conferences were not considered adequate for inclusion in this document. The product labeling approved by the U.S. Food and Drug Administration recommends that women avoid pregnancy during treatment and for at least one ovulatory cycle after methotrexate therapy (Patients can be counseled that available evidence, although limited, suggests that methotrexate treatment of ectopic pregnancy does not have an adverse effect on subsequent fertility or on ovarian reserve. Previous protocols have required multiple methotrexate doses with or without citrovorum rescue. For information on cookies and how you can disable them visit our You may be trying to access this site from a secured browser on the server. Vigorous activity and sexual intercourse should be avoided until confirmation of resolution because of the theoretical risk of inducing rupture of the ectopic pregnancy. Ovarian responsiveness in women receiving fertility treatment after methotrexate for ectopic pregnancy: a systematic review and meta-analysis. However, compared with laparoscopic salpingectomy, medical management of ectopic pregnancy has a lower success rate and requires longer surveillance, more office visits, and phlebotomy. American College of Obstetricians and Gynecologists. Atri M, Bret PM, Tulandi T, Senterman MK. (Level III)59. 1. (Level II-3)26. (Level III)62. Early pregnancy loss. Clayton HB, Schieve LA, Peterson HB, Jamieson DJ, Reynolds MA, Wright VC. (Level II-2)46. Lipscomb GH, Bran D, McCord ML, Portera JC, Ling FW. Cost-effectiveness of presumptively medically treating women at risk for ectopic pregnancy compared with first performing a dilatation and curettage. Am J Obstet Gynecol 1993;168:1759–62; discussion 1762–5. Most cases of tubal ectopic pregnancy that are detected early can be treated successfully either with minimally invasive surgery or with medical management using methotrexate.